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Why I no longer attend unassisted births

8/19/2014

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Its been some time since I made an entry into this blog. Last year was an eventful year. I attended many beautiful, amazing births and witnessed not only babies being welcomed gently into the world but strong empowered families being born :) I felt blessed to be a part of such significant and intimate life events.

Then in Ramadhan last year, two events happened to me that brought this feeling to a screeching halt. I won't go into the details here, but at one of the births, I arrived after baby was born and mom was lying in a pool of her own blood barely moving. I told the father to call the ambulance and luckily the ambulance came in time, and mom received a transfusion. In another birth, mom's placenta wouldn't expel, and the mother almost lost her uterus. Prior to this, I had witnessed about 15 -20 labour & births - most of them unassisted at home. All of them turned out well. I had heard of a few cases of babies who died in unassisted births in the Klang Valley prior to this. I was, needless to say, affected by these stories, but not nearly as deeply affected as I was by these two incidents that happened in front of my eyes. These two incidents made me think long and hard about what I was doing.

Of course it was awe-inspiring to witness mothers & fathers transform into empowered parents & babies being welcomed gently into the world, surrounded by love; but at the same time, I had to ask myself what I would do if a tragedy occurred while I was there. Would I be able to live with myself if that mother died, or if the other mother lost her uterus? ...And the answer would be an unequivocal no. 

Usually after the baby is born, without fail, the mother or father would turn to me and say "Thank you!" - the two words I was never comfortable hearing at a birth - knowing full well I didn't deserve an ounce of credit. I would smile back and say "Oh but I didn't do anything". The more I reflected on this, the more I realized that no matter how prepared the mother & father are for an unassisted birth, my being at the birth would inadvertently create a sense of dependence on me, no matter how small... not so much when things went right, but definitely when things go awry. I have heard the phrase "we would just feel more comfortable if someone experienced is around" said to me all too often. 

I realized that if I were to continue to attend these births, I would be providing a false sense of security to the parents - which would be unfair for both the parents AND myself. Personally, I LOVE homebirth, and I would probably birth at home if ever I have another baby, BUT as a Childbirth Educator, I'm concerned about how my words can influence families' birth decisions. My role is merely to provide information and help families make informed decisions. Ultimately it is the families who must empower themselves by owning and taking responsibility for their own decisions. Regardless of whether UCs are safe or not (countless deaths happen in hospitals too), I decided I could not continue to act in a capacity that is beyond my scope, by attending unassisted births. 

I NEVER deserved the credit for when things go amazingly well, and similarly I could not bear the responsibility for when things go wrong. "You know, there is a reason it is called UNassisted birth", said a colleague to me... and for the first time, I understood what it meant.

Immediately after those two incidents, I related the stories of those mothers to my colleagues in the birth community and in not so many words pre-empted them. Surprisingly, or perhaps not surprisingly, they were unfazed. Ironically, a couple of months later, a mother in the Klang Valley died while having an unassisted birth, and the month following that, another mother died.

The Gentle Birthing Group came under alot of flak by the medical community, although none of the admins were part of either of those two births/ deaths. We issued a statement saying we do not advocate UC, but still we were blamed. The truth is GBG had never been a UC group. And UC stories had been circulating in Malaysia long before GBG came into existence. The GBG has always respected & supported women's choice of where and with whom to birth, and it has focused its efforts on increasing awareness and improving birth options in Malaysia. But because it is the only public platform on facebook promoting gentle birth, it was singled out as being responsible for spreading dangerous ideas.

It is an unfortunate situation that here in Malaysia there is a sore lack of natural birthing options. I completely understand the very difficult position of birthing families here in Malaysia. I myself was in that position before and remember feeling completely disempowered with the lack of options available. It should NEVER be the case that birthing families are forced to chose between two very black or white options (medicalized, mechanized birth in a hospital OR unassisted birth), simply because there is a lack of proper care and options. I dream of a day when families in Malaysia will have the option to birth at a birthing centre with midwives and have midwife-assisted or doctor-assisted homebirths ; and this I believe is the direction to focus on, moving forward.

Since I made the decision to stop attending unassisted births, I've attended a few hospital births and they've truly been eye-opening. I believe mothers who birth at the hospitals need Doulas/ birthing companions more so than the mothers who birth at home! There is so much more going on in the hospital that can interrupt the natural flow of labour & birth. And the Doula has a crucial role to play in protecting the mother's space and supporting the Dad while both of them work to welcome their baby gently into the world. 

I also intend to concentrate on improving birth in hospitals/ birth centres. There are still millions of mothers who birth in government hospitals and THIS is truly where change needs to happen. I pray that Allah puts barakah in my work and guides me to the right path.

To all the families whose births I attended in the past, thank you for including me in such a significant, intimate time of your lives.. truly the power was ALL YOURS (with the permission of the Almighty) and I will cherish those memories forever! No matter where or with whom you birth - the difference is IN YOU! 

Ultimately it is the family's right to decide where & with whom to birth, and this I will always respect. 
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Home is where the heart is

7/3/2013

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Picture
I'm so excited to finally find the time to sit and blog about this beautiful birth. About a month ago I attended an unassisted birth of a young mother and father. This was their third baby, and masyaAllah they have such a cute little family. 
A few days before she birthed, Mom was PMing me and ready to birth her baby. At 42weeks and 1 day, I received a text from her in the morning saying she started feeling her surges. I had a class that day and a talk by Ibu Robin in the afternoon. 

After class I rushed to her house. Apparently, the night before she felt intense surges after she nursed her second boy. She didn't get much sleep and was tired. She was doing well though; breathing beautifully through her surges. Her surges were long, but irregular. I stayed for a while during which she ate some lunch, then she told me to go to the talk as she felt it was still some time to go. I suggested for her to rest, and then to try going on hands-and-knees to help baby get into a more encouraging position. I left for the talk, but didn't stay long as her hubby texted to come around 4pm. 
I went to see her and when I entered the room, I noted the scent of amniotic fluid in the air. Mom was doing beautifully - relaxed and doing slow breathing through her surges, lying semi-reclined on the bed. 
She was starting to lose her patience though. "When is baby going to come?" 
"Sometimes babies have a mind of their own" I said. 
She half-smiled.

There was one point when Mom stood up and leaned forward against her husband and started to sway her hips from side-to-side. Her husband was supporting her and kissing her and holding her, and they were in a little dance together moving baby down and out.

Probably the most memorable part of the birth was when Dad kept doing light touch massage up and down Mom's arms and talking in a little girl's voice - meant to mimic their three  year-old daughter. "Nuha works", Mom whispered.. and so Dad continued to do all the impressions of their daughter, Nuha, in all situations imaginable. "Mama, Nuha ada dress!", "Its a dinosaur!". I smiled at the dedication of this couple to each other and their determination to have the most peaceful birth. "Please Allah make it easy for them," I silently prayed.

Mom then went into the toilet and cleared her bowels. After awhile she got up and went into the room and squatted at the foot of the bed. Her instinct was telling her to squat the baby out... some primal noises coming from her.. Soon she became tired. And so she moved to the bed. Dad was there by her side every step of the way - telling her he's there for her, massaging her, wiping the sweat from her face.

Not long after, Mom began to voice her doubts "I don't think I can do this"; "They'll have drugs at the hospital"

Dad and I looked at each other.

"It seems very close" I said.

"I want to go to the hospital!" she said.

"Ok, the best thing is you might birth in the car... shall we get you dressed?"

Mom seemed to change her mind at the mention of getting dressed.

Azan Maghrib was heard, and a peaceful feeling filled the room. Dad and I took turn to say our prayers and be with Mom.

Mom was starting to grunt and make guttural sounds that filled the room. Dad and I held each of Mom's legs up during the surges, as the expulsive surges were taking over her body.


Silence... Calm... Dad lovingly holding Mom while Mom gave into her body's urges.

"I can see the head!" Dad said incredulously with a big grin.

"Really??" Mom said, not believing.

"He's got curly hair!" I smiled.

"Aghhhh!" One last primal sound from Mom and baby's head slowly crowned and was born.

Dad looked at his baby's head being born in sheer awe.

And then another "aggghhh!" and the body rotated to allow the shoulders to come through.

Baby had a nuchal cord. With the next surge, baby's body came out only slightly further and the cord became tighter. So I motioned to Dad to unwind the cord, and when he did, baby started to sputter.

One last surge and baby's body was out.

"Alhamdulillah!" Mom said, visibly relieved.

Dad received baby and slowly put baby on Mom's chest. 

A big smile on Mom and Dad's faces as they gazed at their new baby. Mom looking so refreshed and ecstatic! ...quite the opposite from just a few minutes before ;). 

I left the family alone to bond and enjoy their special moment.

They were chatting when I returned, and I could sense the feeling of pride, gratefulness and joy! 

Alhamdulillah! Allah is the best of architects! A family is born again :)

The placenta came not long after when Mom sat on the toilet bowl. We fed Mom dates and honey so that she would regain some of the energy she expended.

I left feeling warm and fuzzy..

"Thank you Nadine. I don't know what would have happened if you weren't there" came a text from Dad after I had left. I chuckled to myself. I find it so funny when couples say this to me.. because I know I didn't do anything.

Mabrook to the amazing mother, father and baby team who did so beautifully! Nik Umar is so lucky to have such wonderful parents such as yourselves. May he be anak solehah and be the coolness of your eyes. Ameen.

Note: I do not promote unassisted cildbirth. This family decided they wanted an unassisted childbirth because they believed that it was the best for them. They are well-researched and informed and they made and informed decision. They were going to birth unassisted anyway, whether anyone was with them or not. I was just a companion.

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Childbirth - the everyday miracle

5/20/2013

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MashaAllah , SubhanAllah. I still smile to myself thinking of the events of this past Saturday. I was privileged to attend a home unassisted birth of a first time mother. I had missed a few births in the past few months because of home commitments and other issues, but somehow this birth was perfect timing. In fact, I was supposed to have a class that morning, but the mother had to cancel because she was not feeling well.

I got up in the morning thinking it would be an uneventful day, relaxing with my kids. My phone had gone flat in the night and so I charged it and got this mama's SMS at 7am, when she had already texted me at 6am. I rushed to get my kids fed and left them at my mother's house. Her husband was texting me to hurry as he was excited:) "No stop in surges for last 30 mins. Sorry to rush you".

When I got there, mom was on all-fours on her bed riding her surges. Rocking her body back and forth in silence. Her waters had released at 4am and apparently she had wanted to drive herself from her mother's house to her house to birth, but her husband didn't allow it. *chuckle*

I knelt by her to let her know I was there. She acknowledged my presence and returned to attending to her surges. She was quiet, breathing through her surges. She would occasionally scrunch her eyebrows and her fists and moan. 

We reminded her to relax and release the tension in her body. "How do I do that?" she asked. "Smile" I ventured. And soon enough she started to relax.

"I'm comfortable in this position but my hands are tired". So we piled a heap of pillows against the headboard of the bed and she leaned on it, slightly elevated. This seemed to be her position of choice.

Her surges started to patter out and not long after, the tip of baby's head could be seen. Dad was excited by the sight and rushed to get towels. Mom's sister arrived to give support. Mom was still on all-fours breathing and smiling between surges. 


"But every time I relax I can feel his head go back in".  

"That's fine", we said smiling quietly, excited at this point. 

A few relaxing surges later, baby's head slowly emerged, almost all the way.. and then stopped just at the lips, like a turtle-neck sweater that didn't come down all the way.

Time stood still. 

Dad steadied his hands under baby's head.

"Mancungnya hidung dia!" 

Dad and aunty couldn't contain their excitement.

Another smile from mom..

After a couple more surges, baby slithered out wearing his cord around his wrist and with his hands against his chest... as if making du'a :) SubhanAllah.

Dad received baby, and after mom turned around and sat back down, Dad put baby on her chest.

What a beautiful moment.

We helped mom take her shirt off for skin-to-skin with baby. Then her sister and I left the room to let the new family bond and enjoy their magical moment together.

The mother was ecstatic and incredulous. Baby was alert and taking in his new world with bright eyes. They were both tired and enjoyed a good sleep. I left soon after and learned that the placenta came a few hours after that. 

Mother went to the clinic at night and got a few stitches (which she didn't appreciate) and was so happy and grateful for her beautiful birth and baby.

Alhamdulillah ala kullihaal! What awesomeness HE creates everyday in birth, through the simplest yet most profound moments.

I don't usually blog about the births I attend, because its the family's story to tell and not mine.. but it would be a shame not to share the sheer awesomeness of it.. plus mom gave permission.. hehe.

Congratulations and Mabrook to the amazing mother and father! May your son be the coolness of your eyes, and may you live to tell this wonderful tale to his children :)


Note: I do not promote unassisted cildbirth. This family decided they wanted an unassisted childbirth because they believed that it was the best for them. They are well-researched and informed and they made and informed decision. They were going to birth unassisted anyway, whether anyone was with them or not. I was just a companion.

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    A self-confessed birth junkie, I love all things birth and breastfeeding.. I'm so lucky to be able to work with expectant families and share this very special time in their lives with them :)

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